Miller L G, Hays R D
University of California, Los Angeles (UCLA), School of Medicine, USA.
AIDS Read. 2000 Mar;10(3):177-85.
Adherence to combination antiretroviral therapy has a strong impact on virologic response and emergence of viral resistance. However, monitoring adherence in the clinic is difficult. What a patient says or a clinician believes about a patient's adherence may be misleading. Patients with suboptimal adherence may have reduced or undetectable viral loads. On the other hand, viral load may not decrease in patients with perfect adherence because of pretreatment resistance, poor drug metabolism, or other factors. A multidisciplinary approach involving patients, health care professionals, family, and friends may optimize adherence. This article reviews the literature on adherence to antiretroviral therapy, critiques the various adherence measures used by researchers and clinicians, and discusses the clinical implications of adherence to antiretroviral therapy.
坚持联合抗逆转录病毒疗法对病毒学反应和病毒耐药性的出现有很大影响。然而，在临床中监测依从性很困难。患者所说的或临床医生对患者依从性的看法可能会产生误导。依从性欠佳的患者病毒载量可能降低或检测不到。另一方面，由于治疗前耐药、药物代谢不良或其他因素，依从性良好的患者病毒载量可能不会下降。采用包括患者、医护人员、家人和朋友在内的多学科方法可能会优化依从性。本文回顾了关于抗逆转录病毒疗法依从性的文献，对研究人员和临床医生使用的各种依从性测量方法进行了批评，并讨论了抗逆转录病毒疗法依从性的临床意义。
